JOAD Olympian Achievement Award

JOAD Olympian Achievement Award Request for Recognition

Award Requested: Bronze Olympian Indoor Recurve Silver Olympian Outdoor Compound Gold Olympian

Name: ______

Address: ______

City: ______State: ______Zip: ______

Phone: ______Forward Award Presentation to club address: Gender: Male Female ______Date of Birth: ______Club Affiliation: ______Contact Phone: ______

USA Archery Membership Expiration: ______

Jacket Size (First time Olympian Award Only) Adult: X-Small Med XL 3XL Small Large XXL

Type of Round: JOAD Round 70 Meter FITA Outdoor FITA-I

Type of Event: Sanctioned STAR Sanctioned Qualifier Club

Date of Event: ______Organizer: ______

Name of Event: ______Official Present: ______

I hereby certify that the awards requested were shot according to USA Archery JOAD Rules and Guidelines

______Judge Level 5 Signature Level 4 Level 3 Level 2 Please attach a complete, legible and signed copy of scorecard and send to:

USA Archery 4065 Sinton Road, Suite 110 Colorado Springs, CO 80907

Direct any questions to the USA Archery Office: (719) 866-4576 or [email protected]